Optical Q&A Specialty Practices

Q&A Questions fromthe Optical List

This discussion group focuses exclusive-ly on issues relating to Optical Shops.The list is an ASOA member benefit.Sign up today by visiting http://commu-nity.asoa.org/ and clicking on “MySubscriptions” to log in with your username and password. NOTE: You maysign up your optical shop employees—without having them join ASOA—for alow subscription rate of $5 per month.Questions on how to use theservice? Email Susan Younker(Susan@asoa.org).

Q: Who bills vision plans in your

office? Do your billers bill VSP/MESor do your opticians?

Answers From Your Peers• For eight years, the opticians have

billed VSP & MES. Our new opticalteam (one former tech who hasher ABOC and has been thereeight months and a new opticalmanager hired in March) are insist-ing they are too busy and needhelp since “there’s no time to getanything done.”

Our lab provided us with anoptical consultant specializing inophthalmology offices, and he saysalmost all MD offices have their opti-cians bill because the billers do notknow all the lens options and howto bill all the optical line items.

He also advised that for an office

our size (3.5 FTE ophthalmologistsand 2 FTE ABOC opticians), weshould be handling more than 200jobs per month. Currently it’sbetween 130 and 175 (depending ondoctors taking vacations). The“duties” he is referring to include thefollowing:• Selecting and selling eyewear• Dispensing and fitting• Reconciling invoices for framesand labs

• Filing job jackets after dispensing• Collecting patient balances andbilling VSP/MES

• Ordering (data entry on lab soft-ware and in PM system)

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• Follow-ups (tracking jobs, callingpatients)

• Housekeeping (removing clutter,straightening work areas, clean-ing and stocking frames, unpack-ing frames and removing boxes)

• Vendor frame selection meetings(and asking the vendors to tagtheir own frames)

• Keeping department “welcom-ing,” aesthetically pleasing, andcleanCurrently our personnel are cre-

ating their own issues. There is aproblem with the opticians being “sobusy” they can only sell and dis-pense, but they need help fromother departments for data entry,billing, filing, unpacking and taggingframes, calling patients, etc. They arechoosing the parts of their job thatare convenient for them, the onesthey like to do.

I already know what our expertsaid, now I want to hear it fromother offices.

What do you require? Howmany docs do you have and howmany jobs do you have monthly?We are an MD-only office and we askall our staff to multi-task and workas a team. Am I asking too much, ordo I have a couple prima donnas onmy hands?• We get two auths from VSP: one

for the exam, one for the materi-als. The materials are billed by theoptical.

• My office situation is very similarto yours. My opticians do all ofthe duties as you outlined withoutcomplaining. I have two officesand two opticals. Each optical hastwo opticians. One optician islicensed and acts as the depart-ment head for both opticals.

• I think it also has to do with howyour optical is laid out. Before Icame to my practice, optical hadone computer shared by three peo-

ple all clamoring to print super-bills, get auths, and bill opticalcharges. I pleaded my case to thedoctors that there should be twolaptops in optical so that the opti-cians could be billing as theyplaced the order. Also, it kept themin optical working rather than inthe lab and more accessible topatients. Our optical sales havegrown exponentially in the pasttwo years—and I have had to addmore staff (two FT opticians, twoPT opticians, one floater clericalperson who is a jack of all trades,and one more optician who is act-ing as a full-time tech right now).According to John Pinto’s bench-marks for optical sales per FTE, weare exceeding our numbers at thispoint. I don’t add staff when peo-ple say they are too busy—therehave to be sales and revenue tojustify adding staff.

• In an earlier life I built and man-aged multiple-site optical dispen-saries all of which were associatedwith physician and OD suites. Theoptician staff at each site did all ofthe tasks you described exceptbilling VSP (which was handled bythe staff working with the doc-tors). We did not enter the jobsinto a practice management sys-tem or order jobs online; we did itall on paper.The list of tasks you have

described is not too much to handlefor full-time opticians. In my officewe had one physician (who veryrarely wrote an Rx) and two part-time ODs—thus fewer FTEs than youhave. We could knock out 200+sales/dispensings per month.

I think your consultant’s mini-mum target of 200 per month is veryreasonable. Two opticians should beable to handle that sales volumewithout breaking a sweat and with-out neglecting other duties.

If you are working 22 days amonth and were to do 225 sales,that would only be 10 per busyday—five per optician. Easy, easy,easy, and lots of time left over forthe other administrative tasks onyour list.

If your two opticians are onlydoing 175 jobs per month thenthat’s about four per optician perday. What are they doing whenthey’re not face-to-face withpatients?

It starts with the lead (manag-ing) optician. If that person is notself-driven, then the problems youdescribe are a natural consequence (adomino effect) of laziness and excus-es. To paraphrase Yoda: “There is nocan’t, just won’t.”

Answer From an Expert,Arthur De Gennaro: The comments in the last responseare well-taken. There are some cir-cumstances, however, that wouldcause opticians to complain thatthey are too busy. Three come tomind:

1. If an optician encounters 10customers but only closes six sales,he or she would expend a lot of timebut generate no revenue.

2. Another is a high number ofremakes. In this case customers keepreturning for service. This eats upvaluable time that could be used forselling.

3. Antiquated systems also chewup time. Using a procedure thatworked when business was half ofwhat it is now may no longer be aworkable solution. Updating andstreamlining procedures is a neces-sary part of business life, as you wellknow.

I’d be interested to hear yourthoughts on the above: Is your dis-pensary suffering from a substandardselling effort, excessive remakes, oroutdated systems? AE

Specialty Practices Optical Q&A

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